Gestational Diabetes in Pregnancy
Causes, Treatment, Health Risks of Gestational Diabetes

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Guide to Gestational Diabetes

Diabetes During Pregnancy

Gestational diabetes is a form of diabetes (excessive blood glucose) that occurs in some women during the later part of their pregnancy. Gestational diabetes affects about 4 percent of all pregnant women - about 135,000 cases of are diagnosed in the United States each year - and is more prevalent among very overweight or obese women, and among women with a family history of diabetes. While this type of diabetes usually disappears after the baby is born, the patient has a higher risk of developing type 2 diabetes later in life.

How is Gestational Diabetes Diagnosed?

There is no clear consensus on what precise level of blood glucose is required to diagnose a case of gestational diabetes. This is because glucose levels naturally rise and fall during pregnancy. Diagnosis of gestational diabetes is based upon the results of an oral glucose tolerance test (OGTT), usually administered when the patient is between 24 to 28 weeks pregnant, although it may be performed earlier for women who have a higher than normal risk for diabetes.

Who is at Risk of Gestational Diabetes?

Women aged 30 years and over.
Women with a family history of Type 2 diabetes.
Women who suffer from obesity (BMI > 30).
Women who have had gestational diabetes during an earlier pregnancy.
Women who have difficulty carrying a pregnancy to term.
Women belonging to certain ethnic groups.

What are the Causes of Gestational Diabetes?

Medical experts are unsure what causes gestational diabetes. At present, attention centers on hormonal problems. During pregnancy, the placenta secretes hormones that help the baby to grow and develop. However, these hormones may block the action of the mother’s insulin, causing a condition known as insulin resistance which means the mother's insulin cannot be properly utilized to regulate blood sugar levels. As a result, glucose builds up in the blood to high levels (hyperglycemia).

How Does Gestational Diabetes Affect Mother and Baby?

As blood sugar crosses the placenta, the baby is exposed to the mom's high glucose level. This excessive level of glucose causes the baby’s pancreas to produce extra insulin, which in turn leads the baby to absorb more energy than it needs to grow and develop. This energy surplus can lead to macrosomia, or a "fat" baby. Babies with macrosomia incur specific health problems, such as damage to their shoulders during birth, and post-natal breathing problems. Also, such babies have a higher risk of developing obesity and type 2 diabetes later in life.

What is the Treatment For Gestational Diabetes?

Treating gestational diabetes typically involves four elements:

1. Maintain Healthy Blood Glucose Levels

Some gestational diabetics require drug treatment or insulin injections to control blood sugar levels. Most patients are able to discontinue this treatment after having their baby.

2. Healthy Eating

Women with gestational diabetes are advised to:

Eat little and often.
Include a low-GI carbohydrate at most meals.
Choose nutrient-dense foods: meaning foods which contain all the necessary nutrition for a healthy pregnancy, including: folic acid, calcium, iron.
Adopt a low-saturated-fat diet.
Eat plenty of dietary fiber.

Note: Advice From American Diabetes Association

  • Nutrition requirements during pregnancy and lactation are similar for women with and without diabetes.
  • Medical nutrition therapy for gestational diabetes focuses on food choices for appropriate weight gain, normoglycemia, and absence of ketones.
  • For some women with gestational diabetes, modest energy and carbohydrate restriction may be appropriate.
  • Patients with gestational diabetes should see a dietitian/nutritionist to ensure they make the healthiest food choices for themselves and their baby.

3. Physical Exercise

Taking regular healthy exercise helps to improve insulin sensitivity, combats high glucose levels, assists weight control and prepares you for the birth of your baby. For a suitable exercise routine, check with your physician.

4. Weight Management

While not a direct cause of gestational diabetes, obesity or severe overweight is strongly associated with the incidence of type 2 diabetes as well as other metabolic disorders such as insulin resistance syndrome and cardiovascular disease. Therefore, if you have gestational diabetes, it's important to limit weight gain during pregnancy by maintaining the proper level of calorie intake and expenditure. A nutrient dense GI Diet is probably the best diet plan. For specific advice, check with your doctor.

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GI Value For Whole Grains provides general information about the glycemic index (GI), glycemic load (GL), low GI diets, GI values for all food groups, health problems of high blood glucose including metabolic disorders such as pre-diabetes, impaired glucose tolerance, insulin resistance, hyperinsulinism as well as type 1 and type 2 diabetes. But no information is intended as a substitute for medical advice. Copyright 2003-2021.